ABSTRACT
Objetivo: Evaluar la eficacia y la seguridad del anakinra en el tratamiento de la artritis reumatoide (AR) mediante una revisión sistemática de la evidencia científica. Material y método: Búsqueda en MEDLINE, EMBASE y el registro de estudios Cochrane desde el año 2000 hasta febrero de 2006 según una estrategia prediseñada de perfil sensible que incluyó todos los estudios controlados y aleatorizados (ECA) que evaluaron la eficacia o la seguridad del anakinra en el tratamiento de la AR. Resultados: Se incluyó 4 estudios para evaluar la eficacia del anakinra y un estudio para evaluar su seguridad. En todas las mediciones de eficacia analizadas, se observó un efecto beneficioso del anakinra respecto a placebo y del anakinra + metotrexato (MTX) respecto a la monoterapia con MTX. La combinación de anakinra y etanercept no fue más eficaz que el etanercept en monoterapia y, en cambio, incrementó la incidencia de infecciones graves. La tasa de suspensiones por reacciones adversas al anakinra fue discretamente superior a la del placebo, si bien se puede considerar que el anakinra es un fármaco bien tolerado y seguro a corto plazo cuyo efecto adverso más frecuente es la inflamación local en el punto de inyección. Conclusiones: El anakinra es una alternativa eficaz y segura para tratar a corto plazo la AR. Esta revisión no permite extraer conclusiones sobre la eficacia y la seguridad de este fármaco a largo plazo (AU)
Objective: To perform a systematic review for evaluating efficacy and safety of anakinra in the treatment of rheumatoid arthritis (RA). Material and method: The MedLine, Embase, and Cochrane Library databases were searched from January 2000 to February 2006 by using a high sensitive search that included every randomised controlled trial (RCTs) or controlled trial (CTs) that evaluated either efficacy or safety of Anakinra for the treatment of RA. Results: The search identified four relevant studies to evaluate efficacy. Patients treated with anakinra achieved significantly better clinical responses than those treated with placebo. Anakinra combined with methotrexate provided significantly greater clinical benefit than methotrexate alone. Combination therapy with etanercept and anakinra provides no added benefit and an increased safety risk compared with etanercept alone. Results from a large, placebo-controlled safety study demonstrate that anakinra is safe and well tolerated. The most common adverse effect was a mild local inflammation over the puncture area. Conclusions: This review confirmed both the efficacy and the safety of anakinra in the short term for the treatment of RA. Anakinra provides adequate clinical responses without major safety problems. This systematic review does not allow us to conclude on Anakinra responses in the long term (AU)
Subject(s)
Humans , Arthritis, Rheumatoid/drug therapy , Tumor Necrosis Factors/antagonists & inhibitors , Receptors, Interleukin/antagonists & inhibitors , Antirheumatic Agents/therapeutic useABSTRACT
OBJECTIVE: To perform a systematic review for evaluating efficacy and safety of anakinra in the treatment of rheumatoid arthritis (RA). MATERIAL AND METHOD: The MedLine, Embase, and Cochrane Library databases were searched from January 2000 to February 2006 by using a high sensitive search that included every randomised controlled trial (RCTs) or controlled trial (CTs) that evaluated either efficacy or safety of Anakinra for the treatment of RA. RESULTS: The search identified four relevant studies to evaluate efficacy. Patients treated with anakinra achieved significantly better clinical responses than those treated with placebo. Anakinra combined with methotrexate provided significantly greater clinical benefit than methotrexate alone. Combination therapy with etanercept and anakinra provides no added benefit and an increased safety risk compared with etanercept alone. Results from a large, placebo-controlled safety study demonstrate that anakinra is safe and well tolerated. The most common adverse effect was a mild local inflammation over the puncture area. CONCLUSIONS: This review confirmed both the efficacy and the safety of anakinra in the short term for the treatment of RA. Anakinra provides adequate clinical responses without major safety problems. This systematic review does not allow us to conclude on Anakinra responses in the long term.
